Arthroscopy Sports Medicine and Rehabilitation · September 28, 2026 · LoE II
Both Knotless and Traditional Knot‐Tying Suture Anchors Result in Favorable Clinical Outcomes in the Treatment of Acetabular Labral Tears: A Systematic Review
David Hou, Laura C.M. Ndjonko, Samuel R. Johnson, Patrick England, Ujash Sheth, Vehniah K. Tjong — Northwestern University
This systematic review pooled 10 studies (knot-tying n=425, knotless n=1084 patients) comparing knotless versus traditional knot-tying suture anchors for arthroscopic hip labral repair in FAI patients. Both groups showed significant improvement in modified Harris Hip Score, with the knotless group improving more (24.05 points, 95% CI 23.65-24.44) than the knot-tying group (18.69 points, 95% CI 15.67-21.71, I2 94.5%), though other PROs, revision rates, and THA conversion rates were similar between groups. Complication profiles differed somewhat (more synovitis and suture reaction with knot-tying, more paresthesia and stiffness with knotless), with only synovitis reaching statistical significance.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersHip arthroscopists choosing between knotless and knot-tying anchors for labral repair can be reassured both options yield good outcomes, though the mHHS signal favoring knotless warrants cautious interpretation given major heterogeneity and no formal meta-analysis.
Conclusion strengthConfirms prior evidence
A critical methodological failure for a review.
Presenting this at rounds? Start here
- ?If mHHS improvement appears larger with knotless anchors but other PROs show no difference, how should this inconsistency affect anchor choice in practice?
- ?Given similar revision and THA conversion rates between anchor types, should cost and surgeon familiarity be the deciding factors in selecting suture anchor technique for labral repair?